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Cecile DelCourt, Gwendoline Moreau, Audrey Cougnard-Gregoire; The potential of cardiovascular risk factors for reducing visual impairment: a pooled analysis of European epidemiological studies. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2209. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To estimate the proportion of visual impairment (VI) that could potentially be avoided if the population was not exposed to cardiovascular risk factors.
The European Eye Epidemiology (E3) consortium is a collaborative network of epidemiological studies. Fourteen cross-sectional population-based studies from 9 European countries were included in a pooled analysis of individual participant data. VI was defined as best-corrected visual acuity < 20/60 at better eye. Cardiovascular risk factors included smoking, diabetes, hypertension, obesity and overweight, hyperlipidemia and history of cardiovascular disease. Multivariate mixed logistic regression models, using a random effect for studies, were used to estimate the odds-ratios of the associations of cardiovascular risk factors with VI. The proportions (95% CI) of VI due to the risk factors were estimated using population attributable fractions (PAF). PAF were calculated for statistically significant risk factors from the odds-ratios and the prevalence of the risk factors in subjects with VI, and their confidence intervals (CI) were estimated by bootstrapping.
55,467 subjects, aged 45 years or more, were included in the analysis. In the multivariate analysis including all risk factors, higher risk of VI was significantly associated with age (p<0.0001), female gender (p=0.02), smoking (p=0.0002), diabetes (p=0.001) and cardiovascular disease (p<0.0001), while decreased risk of VI was significantly associated with secondary and higher education (p=0.0002), and overweight and obesity (p=0.01). No statistically significant associations were found with hypertension and hyperlipidemia. PAF was 4.8% (95% CI: 2.7-6.8) for current smoking, 4.6% (95% CI: 2.9-6.4) for diabetes, 6.2% (95% CI: 3.5-8.8) for cardiovascular disease and 12.9% (95% CI: 9.5-16.5) for any of these 3 risk factors. PAF for cardiovascular risk factors were higher for men (23.7% for any risk factor, 95% CI: 16.7-31.0) than for women (9.3%, 95% CI: 5.2-12.7).
Our study shows that VI might be reduced by more than 10% if cardiovascular risk factors could be avoided, with a greater effect in men (23.7%) than in women (9.3%).
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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